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目的探讨乳腺MRI对乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS-Mammography)分类中无钙化乳腺恶性病变的诊断价值。方法搜集行手术治疗且术前已行MRI、乳腺X线摄影中未发现钙化灶的乳腺恶性病变患者共123例,回顾性分析不同BI-RADS分类无钙化恶性病变在MRI上的影像学特点并与组织病理学相对照。统计学分析采用SPSS 13.0统计软件,P<0.05为差异有统计学意义。结果乳腺MRI对无钙化恶性病变诊断的敏感性(98.4%)高于乳腺X线摄影(41.6%)(P=0.000),MRI对BI-RADS-Mammography分类中肿块型病变诊断的敏感性(100%)高于乳腺X线摄影(82.8%)(P=0.001),对非对称致密型病变诊断的敏感性(96.8%)高于乳腺X线摄影(54.8%)(P=0.000),对纤维腺体结构紊乱型病变诊断的敏感性(100%)与乳腺X线摄影(88.9%)相比差异无统计学意义(P=1.000)。MRI对乳腺X线摄影显示阴性的病变诊断敏感性为96.3%,致密型乳腺中,MRI诊断的敏感性(98.3%)高于乳腺X线摄影(66.1%)。MRI对术前病变范围判定的准确性(69.6%)高于乳腺X线摄影(35.9%)(P=0.000)。结论 MRI对乳腺X线摄影中表现为肿块型及非对称致密影的乳腺病变的定性诊断具有优势,对表现为纤维腺体结构紊乱病变的诊断价值有限;MRI对于术前病变范围的判定优于乳腺X线摄影。
Objective To investigate the diagnostic value of breast MRI in the non-calcified breast malignant lesions in the classification of breast imaging reporting and data system (BI-RADS-Mammography). Methods A total of 123 patients with malignant breast lesions who had undergone surgery and had preoperative MRI and mammography without calcification were enrolled in this study. The imaging features of MRI-free malignant lesions with different BI-RADS classification were retrospectively analyzed. In contrast to histopathology. Statistical analysis using SPSS 13.0 statistical software, P <0.05 was considered statistically significant. Results The sensitivity of breast MRI in the diagnosis of malignant transformation without calcification (98.4%) was higher than that of mammography (41.6%) (P = 0.000). The sensitivity of MRI to the diagnosis of mass lesions in the BI-RADS-Mammography classification %) Was higher than that of mammography (82.8%) (P = 0.001), and the sensitivity to asymmetric densification was 96.8% higher than that of mammography (54.8%) (P = 0.000) There was no significant difference (P = 1.000) between the diagnostic sensitivity of glandular structure disorders (100%) and mammography (88.9%). MRI showed a sensitivity of 96.3% for mammography-negative lesions, and for dense mammograms (98.3%) than mammograms (66.1%). The accuracy of MRI in determining the extent of preoperative lesions was higher (69.6%) than in mammography (35.9%) (P = 0.000). Conclusions MRI has the advantage of qualitative diagnosis of breast lesions manifested by mass-type and asymmetric dense shadow in mammography, and has limited diagnostic value for the manifestation of fibrous glandular structure disorders. MRI is superior to the preoperative evaluation of lesions Mammography.